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Arthroscopic-Assisted Lower Trapezius Tendon Transfer

March 01, 2020

Contributors: Collier Campbell, BS; Charles Andrew Daly, MD; Kevin Xavier Farley, BA; Michael Brandon Gottschalk, MD, FAAOS; Thomas M Neustein, MD; Eric R Wagner, MD

Management of massive, irreparable rotator cuff tears is a challenge. Multiple treatment options, including open or arthroscopic tendon transfer, are available for the management of massive, irreparable rotator cuff tears. Arthroscopic-assisted techniques have markedly improved surgeons' ability to re-establish the posterior aspect of the force couple in patients with an irreparable infraspinatus tear. We prefer lower trapezius transfer given its superior line of pull to the latissimus and because it is an in-phase transfer. This video discusses the case presentation of an active, 61-year-old woman with a massive, irreparable, posterosuperior rotator cuff tear who underwent arthroscopic-assisted lower trapezius tendon transfer. In appropriately selected surgical candidates with a massive or irreparable rotator cuff tear (ie, young and active patients with no or minimal glenohumeral head osteoarthritis), arthroscopic-assisted lower trapezius tendon transfer allows surgeons to re-establish the posterior aspect of the shoulder's force couple and incorporate partial rotator cuff repair. Several studies have reported improved external rotation, overall shoulder function, range of motion, quality of life, and pain after lower trapezius tendon transfer.

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